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Heart healthy whole grains and the new agenda for the Wheat Lobby

By Dr. Davis | February 6, 2013

This recent Six Servings post from our nice friends at the Wheat Lobby prompted me to make this counterpost.

Their post begins with:

According to the American Heart Association, the best way to keep your heart in peak form is by eating well and maintaining a healthy lifestyle. Whole grains are a cornerstone of a heart-healthy diet and consuming them has been associated with a reduced risk of heart disease by keeping blood pressure, cholesterol – and even weight – in check. Because of these benefits, the Dietary Guidelines for Americans recommends making at least half your grains whole grains. By following this simple recommendation, you will be well on your way to giving your heart a little more love.

I’d like to contribute my thoughts to this grain-based love fest.

Now, when we’re talking about heart disease, we’re talking about a topic I know something about. Having practiced cardiology essentially 7 days a week, 50 weeks a year for the last 23 years, having been involved in the care of tens of thousands of people with a wide variety of heart conditions, having performed 5000 heart catheterizations, thousands of coronary angioplasties, directional/rotational/translumiminal-extraction/excimer laser angioplasties, stent implantations, intracoronary ultrasounds, treated thousands of heart attacks and cardiac arrests, performed tens of thousands of stress tests in various forms, echocardiograms, and participated in research in heart disease, I think about heart disease, I talk about heart disease, I write about heart disease . . . so, let’s talk about heart disease, specifically coronary heart disease and coronary atherosclerosis, the conditions that lead to heart attack and the “need” for procedures like heart catheterizations, angioplasty, stent implantation, and bypass surgery.

As followers of the Wheat Belly discussion already know, data like the Physicians Health Study and the Nurses Health Study and the 12 other studies often cited that “prove” that whole grains are heart healthy actually do no such thing. They only demonstrate that, if white processed flour products are replaced with whole grains, there are indeed health benefits, including a reduced risk for cardiovascular disease. But they do not demonstrate that whole grains improve health over no grains. So let’s ask: What happens when non-wheat/grain consuming people consume “healthy whole grains” on factors relevant to heart health:

—Increased levels of de novo lipogenesis–The human liver is an efficient “machine” for converting dietary carbohydrates, such as the amylopectin A and amylose of wheat, to triglyceride-containing particles released into the bloodstream or stored in the liver. Eat more wheat and particles like very low-density lipoproteins (VLDL), signaled by increased triglycerides on a lipid panel, increase. Some remain in the liver, also; if enough are retained over time, “fatty liver” develops. High triglycerides also result in increased degradation of HDL particles: low HDL cholesterol, another cardiovascular risk.
—Increased small LDL particles–The increased availability of VLDL particles in the bloodstream from grain consumption triggers a series of blood events that result in the formation of explosive quantities of small LDL particles. Typical small LDL of a non-grain consumer: 0 nmol/L small LDL particles. Typical small LDL of a whole grain-consumer: 600-1800 nmol/L–yes, explosive. Small LDL particles are not only more inflammatory, poorly recognized by the human liver, preferentially taken up by inflammatory white blood cells (macrophages) residing in the walls of atherosclerotic plaque, but they are also uncommonly long-lasting, typically lasting 7-10 or more days, compared to the 24 or so hours of large LDL particles. Small LDL particles are perfectly crafted to create coronary heart disease. One wheat indulgence = increased risk for heart disease for 7-10 days.
—Increased fasting glucose and HbA1c–Eat foods that raise blood sugar and blood sugar goes up. I recognize how obvious that sounds–what knucklehead could not see this?–but that basic truth escapes people like the Wheat Lobby and their friends at places like the American Diabetes Association. High blood sugar after eating is reflected in the HbA1c value. Repetitive high blood sugar creates resistance to insulin and damage to pancreatic beta cells that produce insulin–fasting blood sugar goes up, pancreatic beta cell function becomes impaired, blood sugars go up farther . . . diabetes. Now that people are, to a greater and greater degree, heeding advice to consume more “healthy whole grains,” they are experiencing the worst epidemic of diabetes ever witnessed in the history of man on earth.
—Increased visceral fat accumulation–As increased glucose/insulin does its work, the trigger for fat accumulation in visceral fat stores proceeds and fat collects around the abdominal organs (and heart), signaled on the surface by a protuberant abdomen, “muffin top,” “love handles,” etc. The more visceral fat, the greater the cardiovascular risk, as much as 2-4 fold greater. Also, recall that visceral fat is also inflammatory fat, reflected in inflammatory measures like higher c-reactive protein.
—Impaired nutrient absorption–Grain consumers due to exposure to phytates, lectins, and wheat gliadin, have reduced absorption of magnesium, folate, vitamin B12, vitamin D, and other nutrients which can add up to increased cardiovascular risk.
—Increased dental disease–The increased dental caries (cavities), gingivitis, dental plaque, tooth loss, and dental/facial deformities of wheat/grain consumption are increasingly being recognized as cardiovascular risk factors. Note that, even 100,000 years ago, before the availability of tooth brushes, toothpaste, dental floss, fluoridated water, and dentists, dental decay was uncommon, affecting less than 1% of teeth, compared to the 16-50% of teeth affected in wheat/grain consumers before vigorous dental hygiene became the norm.

Those are the biggest reasons why “healthy whole grains” are most definitely not heart healthy if your comparison group are non wheat/grain consumers.

The people in the Wheat Lobby are not entirely stupid. They fell into this nutritional trap, just as most people did, lulled by the flawed logic of nutrition and the flawed construction of epidemiologic observations. I believe that, more recently, they have smartened up. Rather than admit their logical errors–which would be disastrous for their industry!–they have chosen a second best: draw attention away from wheat and shine the spotlight on other grains such as quinoa and buckwheat. (Their current post features a recipe for Quinoa, Sweet Pepper, and Fig Salad–no wheat.)